Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-25T18:16:47.280Z Has data issue: false hasContentIssue false
  • English
  • Français

Resilience and Challenges among Staff of Gulf Coast Nursing Homes Sheltering Frail Evacuees following Hurricane Katrina, 2005: Implications for Planning and Training

Published online by Cambridge University Press:  28 June 2012

Sarah B. Laditka ,
James N. Laditka ,
Carol B. Cornman ,
Courtney B. Davis  and
Jane V.E. Richter
Sarah B. Laditka*
Affiliation:
Associate Professor and Master of Health Administration Program Director, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
James N. Laditka
Affiliation:
Associate Professor and Health Services Research Doctorate Program Director, Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
Carol B. Cornman
Affiliation:
Director of the Office for the Study of Aging, University of South Carolina, Columbia, South Carolina, USA
Courtney B. Davis
Affiliation:
Research Associate, Office for the Study of Aging, University of South Carolina, Columbia, South Carolina, USA
Jane V.E. Richter
Affiliation:
Director, Center for Public Health Preparedness, University of South Carolina, Columbia, South Carolina, USA
*
Department of Public Health SciencesUniversity of North Carolina at Charlotte9201 University City BoulevardCharlotte, North Carolina 28223USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Purpose:

The purpose of this study was to: (1) explore experiences and responses of staff in caring for sheltered, frail, Hurricane Katrina evacuees; and (2) identify how planning and training can be enhanced for staff who may care for frail older populations during and after disasters.

Methods:

Individual, in-person, semi-structured interviews were conducted with 38 staff members in four nursing homes in Mississippi, sheltering 109 evacuees in November 2005, nine weeks after Hurricane Katrina.Twenty-four were direct care staff, including certified nursing assistants, licensed nurses, dietary aides, and social workers; 14 were support staff, including maintenance and business managers. The number interviewed in each nursing home averaged 9.5 (range 6–15). Using a discussion guide and focusing on their experiences caring for nursing home evacuees, staff were asked to describe: (1) experiences; (2) problems; (3) what helped; and (4) what was learned. Data were processed using grounded theory and thematic analysis. Responses of direct care staff differed in emphasis from those of support staff in several areas; responses from these groups were analyzed separately and together. Three of the researchers identified recurring themes; two organized themes conceptually.

Results:

Staff emphasized providing emotional reassurance to evacuees as well as physical care. Many described caring for evacuees as “a blessing,” saying the experience helped them bond with residents, evacuees, and other staff. However, caring for evacuees was difficult because staff members were extremely anxious and in poor physical condition after an arduous evacuation. Challenges included communicating with evacuees' families, preventing dehydration, lack of personal hygiene supplies, staff exhaustion, and emotional needs of residents, evacuees, and staff. Teamwork, community help, and having a well-organized disaster plan, extra supplies, and dependable staff helped personnel cope with the situation.

Conclusions:

Staff of nursing homes that sheltered Katrina evacuees demonstrated resilience in the disaster's aftermath. Many placed the well-being of residents as their first priority. Results underscore the importance of planning, teamwork, and adequate supplies and staffing. Training for long-term care staff should emphasize providing emotional support as well as physical care for residents and evacuees during and following disasters. Nurses, social workers, and other staff members responsible for promoting emotional well-being for nursing home residents should be prepared to respond to disasters.

Keywords

agingdisabled peopledisasteremergencyfrail elderlyhealthcare workershurricaneHurricane Katrinanursing homespreparednesslong-term caretraining
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 1 , February 2009 , pp. 54 - 62
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Olson, E: Nursing Homes. In: Evashwick, CJ, (ed), The Continuum of Long-Term Care 3rd ed. Clifton Park, NY: Delmar Learning, 2005, pp 295–311.Google Scholar
2. Laditka, SB: Modeling lifetime nursing home use under assumptions of better health. J Gerontol B Psychol Sci Soc Sci 1998;53(4):s177–s187.CrossRefGoogle ScholarPubMed
3. Laditka, SB, Laditka, JN: Effects of improved morbidity rates on active life expectancy and eligibility for long-term care services. J Appl Gerontol 2001;20(1):39–56.CrossRefGoogle Scholar
4. Hyer, K, Brown, L, Berman, A, Polivka-West, L: Establishing and refining hurricane response systems for long-term care facilities. Health Aff (Millwood) (Web exclusive) 2006:w407–w411.CrossRefGoogle Scholar
5. US Office of the Inspector General: Nursing home emergency preparedness and response during recent hurricanes. Available at http://oig.hhs.gov. Accessed 19 February 2008.Google Scholar
6. Knabb, R: Hurricane Lane Tropical Cyclone Report. Available at http://www.nhc.noaa.gov/pdf/TCR-EP132006_Lane.pdf. Accessed 28 January 2008.Google Scholar
7. Dosa, DM, Grossman, N, Wetle, T, Mor, V: To evacuate or not to evacuate: Lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Directors Assoc 2007;8(3):142–149.CrossRefGoogle ScholarPubMed
8. Laditka, S, Laditka, J, Xirasagar, S, et al. : Providing shelter to nursing home evacuees in disasters: Lessons from Hurricane Katrina. Am J Public Health 2008;98:1288–1293.CrossRefGoogle ScholarPubMed
9. [US] Government Accounting Office: Evacuation of hospitals and nursing homes. Disaster preparedness: Preliminary observations on the evacuation of hospitals and nursing homes due to hurricanes. Briefing for congressional committees, 16 February 2006. Available at http://www.gao.gov/new.items/d06443r.pdf. Accessed 19 February 2008.Google Scholar
10. Polivka-West, L: Caring for vulnerable elders during a disaster: National findings of the 2007 Nursing Home Hurricane Summit. 2007 Nursing Home Hurricane Summit. St. Petersburg Beach, FL: Florida Health Care Association; 2007. Available at http://www.globalaging.org/armedconflict/countryreports/americas/2007/summitfinal.pdf. Accessed 10 February 2008.Google Scholar
11. Brown, LM, Hyer, K, Polivka-West, L: A comparative study of laws, rules, codes and other influences on nursing homes' disaster preparedness in the Gulf Coast states. Behav Sci Law 2007;25(5):655–675.CrossRefGoogle ScholarPubMed
12. The White House:The federal response to hurricane Katrina: Lessons learned. Available at http://www.whitehouse.gov/reports/katrina-lessons-learned.pdf. Accessed 16 February 2008.Google Scholar
13. King, R: Flood-ravaged hospitals are diagnosing their needs for this hurricane season. New Orleans Times-Picayune, 21 May 2006.Google Scholar
14. Laditka, S, Laditka, J, Xirasagar, S, et al. : Protecting nursing home residents during disasters: An exploratory study from South Carolina. Prehospital Disast Med 2007;22:46–52.CrossRefGoogle ScholarPubMed
15. Gibson, MJ, Hayunga, M: We can do better. Lessons learned in protecting older persons in disasters. Available at http://www.aarp.org/research/assistance/lowincome/better.html. Accessed 11 January 2008.Google Scholar
16. Aldrich, N, Benson, WF: Disaster preparedness and the chronic disease needs of vulnerable older adults. Prev Chronic Dis 2008;5(1):A27.Google ScholarPubMed
17. Fernandez, L, Byard, D, Lin, C, et al. : Frail elderly as disaster victims: Emergency management strategies. Prehospital Disast Med 2002;17(2):67–74.CrossRefGoogle ScholarPubMed
18. Arnold, J: Disaster medicine in the 21st Century: Future hazards, vulnerabilities, and risk. Prehospital Disast Med 2002;17(1):3–11.CrossRefGoogle ScholarPubMed
19. Gray, BH, Hebert, K: Hospitals in Hurricane Katrina: Challenges facing custodial institutions in a disaster. J Health Care Poor Underserved 2007;18(2):283–298.CrossRefGoogle ScholarPubMed
20. Gulitz, E, Kurtz, A, Carrington, L: Planning for disasters: Sheltering persons with special health needs. Am J Public Health 1990;80(7):879–880.Google ScholarPubMed
21. Friedman, E: Coping with calamity. How well does health care disaster planning work? JAMA 1994;272(23):1875–1879.CrossRefGoogle ScholarPubMed
22. Saliba, D, Buchanan, J, Kington, RS: Function and response of nursing facilities during community disaster. Am J Public Health 2004;94(8):1436–1441.CrossRefGoogle ScholarPubMed
23. Mangum, WP, Kosberg, JI, McDonald, P: Hurricane Elena and Pinellas County, Florida: Some lessons learned from the largest evacuation of nursing home patients in history. Gerontologist 1989;29(3):388–392.CrossRefGoogle ScholarPubMed
24. Silverman, MA, Weston, M, Llorente, M, et al. : Lessons learned from Hurricane Andrew: Recommendations for care of the elderly in long-term care facilities. South Med J 1995;88(6):603–608.CrossRefGoogle ScholarPubMed
25. Menne, HL, Ejaz, FK, Noelker, LS, Jones, JA: Direct care workers'recommendations for training and continuing education. Gerontol Geriatr Educ 2007;28(2):91–108.CrossRefGoogle ScholarPubMed
26. Stone, R: Introduction: the role of training and education in solving the direct care workforce crisis. Gerontol Geriatr Educ 2007;28(2):5–16.CrossRefGoogle ScholarPubMed
27. Stott, AL, Brannon, SD, Vasey, J, et al. : Baseline management practices at providers in better jobs better care. Gerontol Geriatr Educ 2007;28(2):17–36.CrossRefGoogle ScholarPubMed
28. Harris-Kojetnin, L, Lipson, D, Fielding, J, et al. : Recent Findings on Frontline Long-Term Care Workers: A Research Synthesis 1999-2003. Washington, DC: Institute for the Future of Aging Service, 2004.Google Scholar
29. Squillace, MR, Remsburg, RE, Bercovitz, A, et al. : An Introduction to the National Nursing Assistance Survey. Washington, DC: US Government Printing Office, 2006.Google Scholar
30. Paraprofessional Healthcare Institute, Institute for the Future of Aging Services: The role of training in improving the recruitment and retention of direct-care workers in long-term care. Workforce Strategies No. 3. Available at http://www.directcareclearinghouse.org/l_art_det.jsp?res_id=150710. Accessed 27 January 2008.Google Scholar
31. O'Brien, C, Sclod, S, Escamilla, V: PREPARE: A study of disaster planning in senior living. Seniors Housing & Care J 2007;15(1):57–66.Google Scholar
32. Laditka, SB, Laditka, JN, Cornman, CB, et al. : Disaster preparedness for vulnerable persons receiving in-home long-term care in South Carolina. Prehospital Disast Med 2008;23(3):133–142.CrossRefGoogle ScholarPubMed
33. Strauss, A, Corbin, J: Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Thousand Oaks, CA: Sage Publications, 1990.Google Scholar
34. Boeije, H: A purposeful approach to the constant comparison method in the analysis of qualitative interviews. Quality Quantity 2002;36(4):391–409.CrossRefGoogle Scholar
35. Miles, MB, Huberman, AM: Qualitative Data Analysis. Thousand Oaks, CA: Sage Publications, 1994.Google Scholar
36. Reid, WM, Ruzycki, S, Haney, ML, et al. : Disaster mental health training in Florida and the response to the 2004 hurricanes. J Public Health Manag Pract 2005;Suppl:s57–s62.CrossRefGoogle Scholar